Monday, April 14, 2014

I've finished the Come Rain or Come Shine book. It was good, and I think gave a person a lot to think about. I've started In Their Own Voices which is also very good. I think a must-read for anyone who is looking to adopt transracially. They have lots of stories about transracial adoptees of all ages, who grew up in all different circumstances. It's a good one.

I also ran across this blog post the other day on White Sugar, Brown Sugar. You can find it here. I think it's a good recap of the loss and pain that adoption can bring, as well as the joy.

Wednesday, April 2, 2014

There is a bill in front of the Nebraska legislature right now that would expand the scope of practice for Optometrists in our state. It would allow them to prescribe more medications - such as oral immunosuppressives and glaucoma medications. It would allow them to do minor eyelid procedures like removing eyelid lesions and I&D chalazia. Across the country right now there are bills in the various state legislatures that expand the scope of practice for optoms.

As an ophthalmologist, these bills are a threat to my profession. Optometrists are the primary care doctors of the eye, we are the surgeons. Two separate entities. Both necessary.

A few days ago, someone from the Nebraska Association of Eye Physicians and Surgeons asked me to participate in a panel discussion about the bill on a tele-town hall meeting. I agreed. I barely talked through the whole thing. The only thing I said was in regards to the relationship between Optometrists and Ophthalmologists, and I said that in my experience, most people go to an optometrist first and are evaluated and then sent on if they need further care. That was it.

So one of the optometrist in town called me tonight. Livid. Yelling. Telling me I was arrogant, egotistical, and that I had no idea what I had just done to my life here. Saying that I thought Optometrists were second class citizens. I kept saying, "no, but we're different", which made him really mad. He tells patients that the only difference between me and him is that I can do surgery and he can't. Ahem. That is not the only difference. But I was comparing a family doc with a general surgeon. One is not better than the other, but they are not the same. I did surgery on his mother a few months back. One eye went fine, the other was a bit more complicated, but in the end she ended up just fine. He told me I "ruined" her eye, and that most people would take that as a little bit a humility, but not me. He has no idea how many sleepless nights I had over that woman.

He had gotten an email from the President of the state Optometric Association saying that I had participated in this meeting and that I bashed Optometry the entire night. Which wasn't true. But that is how things go. As ophthalmologists we get most of our referrals from Optoms. So that is partly why these bills pass. Because we are too afraid to stand up for our profession at the risk of losing referrals. But we can't do that.

And the crazy part is that out of all of the optometrists in town, I feel he is the least competent. And he is so arrogant about it. He will send me complete train wrecks and then go on and on about how it was already this bad when he first saw them, so it obviously wasn't his fault. And not once have a yelled at him. Asked him why the f#$k he didn't send me so-and-so sooner. Why? Because that is unprofessional, and that is not how you talk to colleagues.

It was one of the more unprofessional encounters of my entire life. And talking to Bonnie and some other people today, I realized that he would have never, in a million years, called Jim at 8:00PM to berate him. Never ever. But I'm a woman, and I'm young, so he feels OK to do that. Well, I am not really OK with that.

Charlie talked to one of the other optoms in town last night about it. He was upset too. Though he didn't call me to berate me. He told me to lie low. Said that it's OK to do all the donating, call your senator, whatever, but don't go public with it. But that is exactly why these bills gain ground. Because too many ophthalmologists are too afraid to say anything for fear of losing their referral base. We have got to stop being afraid.

I will not be bullied. This is something I believe in. It is important to me, and it is important to my profession, and I believe it is important to patient safety. I didn't say much to him tonight, but I did say that if given the chance I would do it again. I will stand up for what I believe in. I will not let you intimidate me into silence. I may look insignificant, but I am vocal. And I will not be silenced.

Now I'm not saying I'm going to start some sort of holy war. The next time he calls me after hours and tries to yell at me (because this is not the first time), I will calmly tell him that I'm not going to talk to him about this right now. That I'll be happy to talk to him at another time, when its not 8:00PM and when we're not seeing patients. And that I will talk to him as long as he is professional. This is not something I expect to see eye-to-eye on. I'm not sure if he is under the impression that every single ophthalmologist in the country is not against these bills or what, but we don't have to agree. That doesn't mean we can't be civil. If he had gone public in support of the bill I would not have given a rats ass, because I assumed he was in favor of it.

So. Bring it. Whatever happens I will figure it out. Maybe this one decision to participate in this tele-town hall meeting will be the end of me in North Platte. Probably not. But either way I will stand up for what I believe in.